Cellcept (Mycophenolate) Medicare Coverage

Cellcept
Chemical name: Mycophenolate

Brand name: Cellcept

Typical dosage: 500mg

Typical type: Tablet1

Cellcept is a medication used in organ transplants. Cellcept is available as a brand name or a generic and comes as an oral capsule, IV injection, an oral liquid or an oral tablet.

Cellcept is a medication that contains the active ingredient Mycophenolate.

Cellcept is used to prevent organ rejection in patients who receive kidney, heart or liver transplants. It is typically taken twice daily for up to 2 years after the organ transplant.

Cellcept suppresses the immune system to allow the body to accept the new organ.

Common side effects of Cellcept include back pain, constipation, headache, dizziness, loss of appetite, stomach pain, diarrhea, gas, fatigue, shakiness, trouble sleeping and joint pain.

Does Medicare cover Cellcept or Mycophenolate?

While some Medicare plans may not cover Cellcept, 100% of Medicare Advantage plans and Medicare Part D plans cover Mycophenolate.1

  • Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). Most Medicare Advantage beneficiaries (88 percent) are enrolled in MA-PDs.2

  • Medicare prescription drugs plans each have their own formulary, or drug list, that details what prescription drugs are covered by the plan and how they are covered.

Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover Mycophenolate.

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Average costs for Mycophenolate with Medicare drug coverage1

Your copay and deductible costs for any prescription drug can vary depending on what coverage stage you’re in.

Deductible stage Typical copay stage
Your deductible is the amount of money you must spend on covered drugs before your Medicare drug coverage starts paying its share of costs.

In the deductible stage, you’re responsible for the full cost of your prescription drugs.

Some Medicare prescription drug plans have a $0 deductible. Medicare drug plans cannot have a deductible more than $415 in 2019.
After you meet your Part D deductible, you enter the initial coverage period.

During this phase (the typical copay stage), you pay a copayment (flat fee) or coinsurance (percentage) for your covered medications.
$5 – $456 Free – $127

Additional information

If you are taking an oral form of Cellcept, take each dose on an empty stomach at least 1 hour before or 2 hours after meals. Avoid taking antacids within 2 hours after taking this medication.

Using Cellcept during pregnancy can cause birth defects and even death of the unborn baby. If you are able to become pregnant, birth control is required to prevent pregnancy while taking Cellcept. A pregnancy test is done right before starting Cellcept and is repeated 8-10 days later to ensure that you are not pregnant.

Cellcept can increase the chances of getting cancer like lymphoma or skin cancer. If you see changes in the color or size of a mole, skin growth, noticeable weight loss, night sweats or swollen glands, call your doctor right away.

Because Cellcept suppresses your immune system, you may be at a higher risk of infection. Watch for signs of infection while taking Cellcept including fever, chills, flu-like symptoms, sore throat, ear pain, cough or wounds that will not heal. Wash your hands often and avoid people with infections, colds or flu while taking Cellcept.

 

 

This article is for informational purposes only. It is not healthcare advice, treatment, or diagnosis. It is not an endorsement of or recommendation for this medication. Speak to your doctor or healthcare provider about your specific healthcare needs, including your prescription medications. Only take medication as directed by your doctor.

Coverage and costs of prescription medications will vary by Medicare plan. Not all plans are available in all areas.

 

Written by Hayden Gharibyar, Pharm.D.